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Periodic Contributor

Recent premium increase for United Healthcare coverages

I am absolutely appalled at the just announced price increases for United Healthcare coverage. The increase in RX (over 90%) announced during the last open enrollment was enough force me to make a change and now the supplemental health coverage increase (22%) is astounding. As their primary selling agent, you should anticipate my changing to another, more affordable carrier at my first opportunity and hopefully a boatload of others doing the same. Shameful, unjustified, heartless, and ridiculous. Shame on both you and United Healthcare.  

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What was the result of aarp working on it?

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(3/19/24) That is AWESOME @LauraA422032 !!!  ๐Ÿ‘ต

 


[*** LAURA @LauraA422032 wrote:

AARP called me this morning and is working it. ***]


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@Winter2025VA wrote

 

. . . . . If enough people complain, MAYBE AARP will care . . . 

+++++++++++++++++++++++

They may โ€œcareโ€ but there is little they can do - they ONLY get royalty payments from UHC for use of their name in the promotion of their product - AARP has nothing to do with the benefits or premiums of the insurance company.

 

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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Hi Gaill.1.

 

I totally agree with you.  They say the squeaky wheel gets the oil.  Well, there are enough squeaky wheels like myself that are AARP members and we should very well voice our dissatisfaction with them and their attaching their name to United Healthcare's supplemental plan with this unaffordable increase!  They could at least give us some options and/or names of other insurers that are cheaper and help us out rather than tell us "we will look into it!"  Baloney!

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@maeella9 

In my other reply to you this am, I gave the Medicare.gov website page where you can find other MediGap insurers in your area - 

 

Now what ways can you or others voice your dissatisfaction with AARP in this matter - just a possible one that is at your finger tips.

-  Perhaps Cancel your membership after you have secured your choice of a AARP/UHC Medigap plan of your choice - you only have to be a member of AARP to secure the plan; not to keep it going - so after that sign on,  they cannot cancel your plan for not being a member.

How long do you think AARP would stick with UHC for their branded Medigap if memberships began to be cancelled?

Why is being a member even a pre-requisite to purchasing an AARP/UHC Medigap plan?  Membership isnโ€™t required to purchase an AARP/UHC Medicare Advantage plan.  

 

If you really want to fix stuff like this for everybody, advocate for Medicare to have a maximum annual out of pocket.  That would pretty much wipe out the need for any MediGAP coverage.  

 

Only a small number of Medicare beneficiaries have a MediGAP plan - WHY, the reason is simple - they donโ€™t need it because they have something else to take its place.

  • Almost 50% of Medicare beneficiaries use a MA plan and not Original Medicare
  • Then of the remaining

- many are dual eligible - meaning they share Medicare (primary) and MediCAID (secondary)

- others have some other type of secondary payer - retiree, military or some other government secondary coverage - like CHAMPVA.

 

.

 

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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Just to add to the analysis of Medigap vs MA:  I chose Medigap as I didn't want to be limited to a particular network.  My sister chose Medigap as she lives out in the country, and there are no networks where she is.   So far I've been happy with Medigap and being able to choose any physician.   My primary is still at a network (Sutter) but it takes forever to see a specialist, and a referral is required.   With Medigap, I can get to a specialist much quicker, and do not require a referral from my primary. 

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@DeannaF752445 

I am sure you are happy with your Medigap plan - it is wonderful coverage to protect ones finances in the event of an expensive  medical event.  

 

Thatโ€™s all that a Medigap plan does - gives you payment coverage for what part of the medical expense Traditional Medicare does not cover based on the plan you have.  The Medigap insurer makes no medical determination.  Traditional Medicare leads the way in determining whether a services is covered.  Most of the time, Medicare does not determine if it was a medically necessary service.  They donโ€™t determine if the service could have been handled by a Primary Care Physician rather than a Special, even though they pay the Specialist more.  If they did it would save health care dollars and help to hold down premiums - Part B premiums and your Medigap premiums.

 

But one of the reasons you like your Medigap is the same reason that many beneficiaries cannot afford a Medigap plan thus they HAVE TO go with a Medicare Advantage plan.

 

OR they are denied a Medigap plan.  Federal law does not mandate that Medigap insurers have to accept people who are less than 65 years old.  There are plenty of Social Security Disablity beneficiaries that have Medicare after they have been disabled for 24 months.  States can legislate coverage and many have but they sometimes limit which plans a disabled person can get - like Plan A or Plan B.  Then those Medigap premiums are extremely high ( $ 400 or more per month) because of the beneficiaries they are covering - usually very high health care cost beneficiaries.  The good thing is that when they do hit 65 years old, they get a do-over and get to pick and choose like they are in their initial enrollment period and the insurers canโ€™t hold their health condition(s) over them during this do-over selection - because they have guaranteed issue rights at that point (hitting 65 years old).

 

But in some states, Disabled people less than 65 cannot even get a Medigap plan.

 

Medicare Advantage plans are for those who cannot afford or donโ€™t want a Medigap plan or have access to Medigap plans.  Medicare Advantage plans are all over the place in type and cost.  Here again, you get what you pay for or what you can afford.  The cheapest is, of course, an HMO with network providers not the type like Kaiser Permanente where they actually have their own providers and facilities.  Then at the other end of the spectrum, there are MA plans that are PPOs and have good networks and the ability to go outside of the network for care for a higher price, of course.

 

So we have an economic class system in our Medicare program - and we have that same economic class system within the Medicare Advantage program.  In most instance, beneficiaries buy what they can afford.  We also have a discrimination curve in our Medicare program - between the ones that get it because they are age 65 and the ones that arenโ€™t 65 years old yet (the disabled).

 

Then there are the other rules about changing Medigap plans and it differs state by state.

 

If you donโ€™t live in a state that has expanded the Medigap guaranteed issue rights then your cannot usually change your Medigap plan without being underwritten.  They can then charge you more if your health warrants it or they can refuse you altogether.  

 

But if you live in one of the few states that allows changing your Medigap plan without underwriting under specific rules then everybody in the state with a Medigap plan pays a higher premium compared to the other states that donโ€™t allow this leniency.

 

Now some beneficiaries who elect for a Medigap have selected the High Deductible version of Plan G (or Plan F if they are eligible for it). MUCH Lower premiums but with a (2024) deductible of $2800 and once met the plan pays just like the regular Plan G (or F).  

 

The good thing about MA plans is that you get to pick and choose and change every year based on your health needs or maybe even for financial needs.  They also offer special needs plans which helps those with chronic conditions and the institution of Medicare supports these.

 

Many people love their MA plans.  Many of them have had lots of medical cost for some condition and their plan has come thru for them just like they were suppose to do.  

 

Managed care is what is utilized in many other countries for their universal healthcare.  It is used to control their health care cost.  They also may utilize โ€œgatekeepersโ€ who are personal care physicians that monitor their care and do any referral as necessary.  

 

Count your blessings that you are most fortunate in your Medicare/Medigap coverage and I hope that the premiums remain within your budget cause they will continue to rise and rise just like Medicare Part B premiums.  

 

Also know that the institution of Medicare can also discontinue plans as they determine feasible - they did it in 2010 and they did it again in 2020.  Course if the plan one is end is discontinued then those beneficiaries are grandfathered in but premiums would also rise in these discontinued plans because those that are left in the plan are getting older and possibly sicker and there is no young blood coming in to balance out the plan.  

 

Just thought I would offer a balanced perspective and can because I have neither - I have another type plan.  I just think the whole thing needs a new design and I could even point to other areas where a lot of work is needed.  

 

Off my Bandwagon now.

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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And when the advantage plan people have to actually USE much health care then they can't afford it because the out of pocket is far more than medigap premiums and the B deductible (if they have G for example). AND when you actually need to use your health insurance you may not pass medical underwriting to switch to a medigap to save money. Then you are really up a creek without a paddle unless you are solidly middle class and/or the system you are using doesn't fire you as a patient and then sue you when you are in collection for failure to pay.

 

I realize you love advantage plans, who knows maybe you even sell them. Agents get about twice as much to sell an advantage plan than a medigap which is one reason why those numbers are going up,

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@CBtoo wrote

And when the advantage plan people have to actually USE much health care then they can't afford it because the out of pocket is far more than medigap premiums and the B deductible (if they have G for example).

===============================

For a Medicare Advantage plan, you can look around and find one that has a lower maximum out of pocket.  In fact, there are some with a MOOP that is around $ 4000.  Yes, of course it is more expensive.

 

The ACOA recently did a comparison of the averages - Medigap premiums + any out of pocket averages about $ 7500 a year and a MAPD premiums + out of pocket = $ 9200 but that also includes the $ 2000 MOOP of the Prescription Drug Program. 

 

Of course it would be more if the beneficiary picks an enhanced plan on the prescription drug program.

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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In what universe does the medigap plus out of pocket average $7500? If people buy the worst supplement maybe, but if they buy G then that is incredibly far from the truth.

For both original medicare and advantage plans you have to pay for B anyway (I am ignoring the extra help program and dual eligible folks, only looking at those of us who pay full price so we compare). In this state even worst case a G supplement is thousands a year less than worst case with a supplement plan..

 

I have G+ extras from UHC, have had it for 6.5 years under the discounts go away in 10 years version rather than they go away in 15 years version and am paying $224.93/mo. Someone else I know who turned 65 in Nov is paying for G without the extras at $104 and loose change a month. Add to that the B deductible and we are good to go. If one were paying a $7500 out of pocket, divide that by 12 and it is $625/mo

 

The MAX G+ in this state when you have no discount at all is $293/mo and loose change. That isn't even close to $625/mo. That is a bunch of thousand LESS than $7500.

 

I have $0 premium Wellcare for my drugs as that is a good fit for me so no expense there for drug premiums. ALL of us now have the $2000 maximum out of pocket for drugs - advantage plans or not. 

 

Again, if you hit your max you will be paying far more in an advantage plan than with a supplement G, counting the premiums. It is FAR FAR FAR cheaper to have a supplement if you are hitting your max. 

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@CBtoo 

From the universe that considers all cost of a MAPD plan vs a Medigap.

 

NCOA.org 12/05/2024 What You'll Pay in Out-of-Pocket Medicare Costs in 2025 

 

When I gave the out of pocket cost for Medigap I was using Plan K.   Plan L would be lower and others even lower - if you have a more lucrative in benefits one - even lower to nothing but the Part B deductible but of course with lower out of pocket cost the premiums got higher.  

 

It is possible for people to pick a Medigap plan that is not so lucrative in benefits and save a REAL bundle on premiums now and into the future.

 

The average Medicare Advantage premium is projected to be $17 in 2025, while Medigap premiums may run anywhere from around $65 to $450 or more, depending on the typo of Medigap plan one chooses and their location.while the average monthly premium for Medicare Advantage plans is projected to be around $17 in 2025.  Yes, everybody pays the Part B premium or it is paid FOR them by their state.   Most everybody pay $185 for their Part B, I pay much more than that because of IRMAA so you see, there are many differences in what people pay for their Medicare.

 

ACOA.org12/02/2022 - What Is the Difference Between Medicare Advantage and Medigap? 

 

Yes, many beneficiaries that choose a Medigap plan initially may find that cost become too expensive after years of being on their Medigap plan.  This comes at a time when some have spent much of their retirement savings already and thus the escalating premiums of a Medigap may become too much for them.  Then they find that they cannot change plans because they have a preexisting condition and are refused other Medigap coverage because they cannot pass underwriting or the insurer updates them on the condition or disallows it for a specific amount of time. 

KFF.org 10/18/2024 - Medigap May Be Elusive for Medicare Beneficiaries with Pre-Existing Conditions 

 

Yes, everybody has to decide for themselves which is best for them - their healthcare and their pocket book.  I, like you, just want them to understand the differences in each of these health coverages and their cost - now and over time and the other things that make a big difference like being able to change plans as needs change.  

 

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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PS 

Premiums are only PART of the story. The maximum out of pocket and what you pay with each visit can add substantially to cost of an advantage plan that can total well above what someone pays in premiums with a supplement and their out of pocket. If you are healthy then you do save money. But when you are not you may not and you may have something wrong with you that you fail medical underwriting  so can't switch to a supplement.


Also networks matter. While they may not be an issue in a large city they may well be in somewhere smaller or in a rural area. If you can't afford to travel to be in network then your costs are substantially higher if you have to pay out of network. Some advantage plans don't cover out of network. With original medicare if someone accept medicare then they are "in network" and your supplement is required to pay if medicare pays. Also no need for a referral approval to see a specialist with original medicare.

I realize for you the sun rises and sets on advantage plans. You always post about them. Based on how you post about them I suspect you are an agent and agents get paid far more to sell an advantage plan than a supplement. I'd imagine that has a lot to do with the growth of advantage plan sales since 70% of people sign up through an agent. 

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@CBtoo wrote:

I realize for you the sun rises and sets on advantage plans. You always post about them. Based on how you post about them I suspect you are an agent 


 

Who are you talking to/about?

 

 

 

 

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@CBtoo 

The final choice is still up to the beneficiary - some folks have prepared for their health coverage after they retire - and they can make the decision for themselves as to when and how they want to spend their money on healthcare.

 

I would rather NOT have a large monthly premium for something I am not using.  A premium that rises with time and conditions.  I would rather pay for my part of my healthcare cost as they occur  however, I would consider a Medigap High Deductible plan since the deductible is very reasonable and the premiums are very low and tend not to rise as much mainly because there are not that many people that opt for them and they maybe, as you say, able to pay their part of the cost.  

 

How high would a regular Medigap Plan G have to go to for you to have to say, enough is enough?  $ 300 - $ 400 - $ 500 or MORE per month?    And this often happens after the beneficiary has been on the plan for a very long time and they are older and their retirement funds have dwindled substantially.

 

The choice is up to the beneficiary and their health and financial condition - their choice - either way - I am just glad there are choices.

 

If one wants and has a Medigap plan - understand how your premiums will increase over time based on the rating method, health care inflation, usage of the plan and any increased risk exposure because the state in which they live has expanded the guaranteed issue provision.  Understand your states roll in these premium adjustments and in the rules of Medigap coverage.

 

Outside forces donโ€™t change the actuary numbers - so prepare for the increases as one gets older and older and times and economic conditions change.

 

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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In my state the top AARP UHC premium is $293/mo for the oldest people.

 

And you then have to to pass medical underwriting to switch to "cheaper" coverage (eg premiums plus out of pocket is less than advantage plan out of pocket) and suddenly have huge medical bills your out of pocket is likely going to go higher than that. If you can't pay high premiums you sure can't pay the even higher out of pocket of advantage plans when you finally need it. In my mind you buy insurance for what you'd need if you have to use and then hope you are a profit center for the company since you'd prefer not to every have to use it. But since no one but snake oil sales people can see the future with that, if you choose to gamble and lose it will cost you far more.

In my mind this is similar to (but not identical to) only trying to buy car insurance for something more than liability only after you have had a wreck. For any state that has a medical writing requirement and you aren't eligible for guaranteed issue (I'd include the birthday and equivalent states as guaranteed issue since you can change without passing medical underwriting) then you have a problem if you end up with an expensive serious issue and then are trapped with a high maximum out of pocket. 

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I am talking ONLY about AARP UHC supp G in my state and the costs here, including the max cost for that plan with no discounts. It doesn't matter what all G's cost all over the country. This is why I am sticking with a company that I don't like. It is the only community rated plan here and will be far cheaper when I am older. The top price in this city for G+ with no discount is $298/mo. Yes there are plenty of G's from other companies that cost a fortune. Yes G's in states with the birthday rule generally cost more. IN MY STATE ONLY COMPARING UHC G it is way cheaper if you are going to use your insurance to have supp g with UHC. END OF STORY.

You are ignoring if they can't afford the supp they sure as heck aren't going to be able to afford the max out of pocket and so many won't get health care, or will have care cut off and be sued when they don't pay and/or have to declare bankruptcy over health care. I make less than 200% of the poverty line. 55% or so of my income goes to premiums and rent. I live in something that resembles a 2 room shoe box. At least when I need to use my health care I won't have to worry I can't be seen as I can't pay the copay or I'll have care cut off or be sued for failure to pay my bill. THAT is what may people who opt for an advantage plan will need to worry about. 

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@CBtoo 

It isnโ€™t that I like MAPD plans or not - they are a choice for the beneficiary based on their needs, including their pocketbook.  

You can change Medicare Advantage plans, most have an embedded Prescription Drug plan, EVERY year based on your health needs.  

 

People donโ€™t have to use an agent or broker, they can also check out SHIP in their state (State Health Insurance Programs) for a volunteer to help them do the selection or change.

 

People pick MAPD plans because it is what they want and can afford IF they cannot afford or want a Medigap plan.  

 

Medigap plans are gonna get more expensive in premium cost just as our Part B premiums increase, as time goes by.  

 

Everybody has different situations,  and therefore choice is important.  Many beneficiaries have had managed care plans throughout their lives, if they have been insured, thus it isnโ€™t a new concept for them.

 

People may have other coverage that acts as a supplement like Medicaid, Tricare for Life, CHAMPVA, Veterans Health Benefits.  They donโ€™t have to have a Medigap to work with Medicare as a supplement.  Then they may have a Retiree Health benefit with their past employer or union and they want to stay with this coverage - many nowadays are a special Medicare Advantage plan designed for their use.  

 

I have no idea about an agents or brokers compensation on the selling of a MAPD plan - whether they are independent agents or captive agents by one particular company - I think that is what UHC has - captive agents.  I do know that this last year, CMS restricted their compensation greatly to the point that they may get nothing for selling a MAPD plan because the insurer has stopped paying them.  

NAIFA.org - 11/01/2024 - DECISIONS TO CUT COMMISSIONS ON MEDICARE ADVANTAGE PLANS ARE BAD FOR CONSUM... 

Thus some consumers if they go to an agent or broker may not even know that these plans exist even if they are the one that is best for them - some agents/brokers will still tell their clients about them.

 

Then again, many beneficiaries donโ€™t even know the Medigap guaranteed issue rules in the state where they live.  Not too long ago there was an 88 year old beneficiary paying over $ 800 a month for her Plan F - it didnโ€™t take long to to figure out that since she lived in NY, she could switch plans and that saved her almost $ 500 a month - but of course the new Medigap plan beneficiaries that she went with are now having to share in the cost of her risk, and it was GREAT.  

 

Beneficiaries should educate themselves on ALL the rules, timing and exposures of each type of coverage - they ALL come from private insurers - Medigap, MA and MAPD - and make the best decision they can for themselves - their health and their pocketbook.   But many times, when 1st deciding, they just say - whatโ€™s the cheapest- and that is not the question they need to ask in this instance because as you say many times it may be a decision that they will have a difficult time changing down the road - depending on a lot of conditions - all of which they need to also know.

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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Trump just cut all the funding from the SHIP program. Hopefully something will happen to change his mind.

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NO, the adjustment to the SHIP funding is within the Budget proposal that is currently before Congress for their consideration as indicated or as they adjust it.

 

Since this is a STATE program, states can also add to THEIR SHIP funding. The program isnโ€™t just for Medicare beneficiaries.

 

A non-profit could be set up to serve such a purpose especially for the Medicare beneficiary - in fact, maybe the nonprofit could be staffed with volunteers from the retirees community of health insurance related professions.  

 

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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Our local news was not accurate then. I hadn't researched it further as the news station that mentioned it is usually pretty accurate. Unfortunately I am reasonably sure my state wouldn't support that program if their federal funding was pulled though. This state doesn't pass things that benefit anyone but the wealthy. No medicaid expansion, no SNAP if you aren't working at least 1/2 time (except for kids in families, regardless of the employment status of parents) and if you aren't working you get 3 months once every 3 years.

We definitely need an organization who can answer questions and educate people about how medicare programs work, etc. the catch would be paying for a program like that as the federal government continues to cut grants (as they are doing in other areas like medical research for example). So lets hope, in the end, SHIP isn't cut.

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@CBtoo  - Maybe you were thinking of this program rather than SHIP

The funding for ACA navigators was cut by CMS / HHS but that was because the numbers evidently did not indicate the need for them.

CMS.gov - CMS Announcement on Federal Navigator Program Funding 

from the link ~

The Centers for Medicare & Medicaid Services (CMS) today announced a reduction in funding for the Affordable Care Act (ACA) Navigator program to $10 million.

. . . . Despite receiving $98 million in the 2024 plan year, Navigators only enrolled 92,000 consumersโ€”just 0.6 percent of plan selections through the FFEs during the open enrollment periodโ€”at a cost of $1,061 per enrollment. Additionally, the average cost per enrollment exceeded $3,000 for 12 of the 56 Navigator grantee organizations. Looking back at the grant period covering the 2019 plan yearโ€”the year before the COVID-19 pandemic under a similar regulatory approachโ€”Navigators likewise enrolled 0.6 percent of total enrollments through the FFEs at a substantially lower cost of $10 million. This previous grant funding level reflects a far more efficient $211 per enrollment. 

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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In my state, SHIP did online Medicare classes - reached a whole lot more folks this way - They concentrated on teaching people about Medicare - all of it - including the various plans - MAPD, Free standing Part B and Medigap.  

 

States, of they think SHIP is important to people who need help picking their various plans (not just Medicare) can fund it and set it up to the best advantage they can - leaving the set appointments to those who can do it any other way - BTW, many of the appointments and question with and to SHIP are about oneโ€™s eligibility for Medicaid.  

 

Maybe SHIP can do like PBS and NPR - ask for donations as well as get money from the state.  

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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And if they can only afford advantage plans and not premiums then they sure as heck are not going to be able to afford to actually use their health plan very much as the costs will eventually end up far higher than the premiums for G+ with UHC. It's like buying car liability insurance only. because coverage beyond that is too expensive. That is fine until you get in an accident and then have no money to repair your car. Then you have no car.

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And, again, it they need to use their health insurance, if they can't afford a supplement they sure as heck can't afford the out of pocket for an advantage plan since that is even higher. The max for G (supp and B deductible) is FAR CHEAPER than the max out of pocket for a supplement. In this state Wellcare has one of the largest formularies and a $0/ mo premium and a $12/mo premium version (which is the better choice if you tae expensive meds). BOTH D with an advantage plan and D with a supplement have the same, identical $2000 max out of pocket starting in 2025 so that is irrelevant in the comparison.

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The deductible nor the out of pocket doesnโ€™t always have to be paid all at once in a MAPD plan  It is all based on the policy design.  There are many - HMO, PPO, POS

 

I know people that have had major surgery, stayed within the guidance of the MAPD plans and for a hospital/ provider bill of several hundreds of thousand, they paid less than $ 2000.  

 

You stay within the guidance of the policy, use network facilities & providers, pay the copays, and whatever else as they occur not all at once.  

 

I don โ€˜t care which people pick - it is all gonna go up in the long run - I foresee that traditional Medicare will adopt more managed care in the future to save health care dollars.  Medigap plans will still be around if people want them but CMS may continue to discontinue those with the more lucrative benefits just like in the past - No more Plan J, No more Plan F or Plan C to new enrollees - they will continue this with Plan G - probably around 2030 since they seem to be doing this about every 10-years.  

You know why - right?  To save traditional Medicare money.

 

As far as Part D - yes, the design is the same whether a basic benefit or an enhanced plan but the MA plan will always have a cheaper cost because it is combined with the rest of the plan in health care savings.

CMS.gov - Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable as CMS Impleme... 

 

From the link ~SEE the heading of:  Lower Average Total Part D Premiums in 2025

The average stand-alone Part D plan total premium is projected to decrease from $41.63 in 2024 to $40.00 in 2025 (a decrease of $1.63). 

  • After the application of MA rebates, which reflects what people in MA plans with prescription drug coverage will actually pay, the average MA plan with prescription drug coverage Part D total premium is projected to decrease from $15.56 in 2024 to $13.50 in 2025 (a decrease of $2.06). 

 

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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It doesn't matter if they have to pay it all at once or over time with respect to the total they are going to have to pay. IF you have to use a lot of healthcare G will be far cheaper than an advantage plan. And with original medicare the adjusted rate is far lower than the original amount billed too. That is how insurance works. There is the billed rate and then the adjusted rate based on the negotiated rate that the provider has with the insurance company. 

In this state with D we have a $0 premium, a $3, $12.30 too, not just the higher ones. 

 

With an advantage plan, the zero premium ones, cheapest out of pocket (in network only in this city is) is $4150 plus the B deductible that offers most of the extras advantage plans offer and includes drugs.

 

The rest of the zero premium ones with meds (around a third of them have no transportation, in home help and about two thirds don't have a cash card or it is $50 or less and almost all of them the B deductible is separate, by federal law the D out of pocket is now separate too and not included in the figures below) the in network out of pocket is:

4,500

5,900

4,400

5,600

7,500

5,900

4,900

6,700

4,900

5,400

7,900

9,350

6,751

5,900

6,900

 

Some of the above have no out of network coverage at all. 

 

Every single one of those is more expensive than my G+ premiums, D premiums, and B deductible together compared to the max with any of this states no premium advantage plans that include a drug plan.

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Honored Social Butterfly

And if you have another Medigap plan other than G, you may have less in premium cost but more in out of pocket. 

 

Is $ 2870 (2025) too much to pay for health care?  Thatโ€™s all one would have to pay for a High Deductible Plan G and the premiums would be MUCH, MUCH lower.  This deductible even includes the $ 257 (2025) Part B deducitble that everybody with a Medigap has to pay - Once that $ 2870 (2025) is met on the HD Plan G Medigap it performs just like any other Plan G.  So one has the best of both worlds.  If everybody had chosen this type of HD Medigap plan, premiums would be a lot lower - in fact even our Part B premiums would be lower because people would think twice before using the benefit for anything that isnโ€™t necessary.  

ITโ€˜S ALWAYS SOMETHING . . . . .. . . .
Roseanne Roseannadanna
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Conversationalist

Your example is yet another reason why a supplement is cheaper than an advantage plan if you end up with enough health care to meet your maximum out of pocket (or meet more than you'd pay with a supplement). I was only comparing G+ and didn't bother to list all the rest of the supplements since G+ from AARP UHC has some of the extras that advantage plans include and it is closer (but not identical) to apples to apples for benefits. 

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Regular Contributor

  That's about the best condensed explanation of how it works!I have said so many times to the advantage plan users "Just wait until you get sick" because then you better have the money (thousands) put away to pay for all that time you had that "free" advantage plan.

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Community Concierge

Hi Nicole! We're sorry to hear youโ€™re having trouble with one of our benefit providers. We are listening and would like the chance to help as soon as possible. Please visit https://help.aarp.org/s/article/contact-aarp to chat, text, or speak with a representative who can get you in touch with our Member Relations team. -Sue J

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